Healthcare Provider Details
I. General information
NPI: 1841850435
Provider Name (Legal Business Name): EVERLY ISABEL COLE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/17/2019
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5212 W VILLAGE PKWY STE 1
ROGERS AR
72758-8190
US
IV. Provider business mailing address
5212 W VILLAGE PKWY STE 1
ROGERS AR
72758-8190
US
V. Phone/Fax
- Phone: 918-289-3350
- Fax:
- Phone: 918-289-3350
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-19-36347 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: